Angela Kristen Devine, DO
Individual provider Active NPI Emergency Medicine Physician · Saint James, NY
NPI 1265992887 · NPPES record last updated Aug 14, 2022
Key facts
- NPI
- 1265992887
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 317811 (NY)
- Practice address
- 25 Stonegate
Saint James, NY 11780-4228 - Phone
- (631) 235-2961
- NPI assigned
- Mar 20, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- John T Mather Memorial Hospital
Practice addresses (Care Compare)
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320
Hospital & facility affiliations
- John T Mather Memorial Hospital of Port Jefferson
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220810002063 | NY | Practitioner - Emergency Medicine | 0648507087 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 317811 | NY | MD | Emergency Medicine Physician |
Practice roles (7 of 11)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John T. Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Emergency Medicine | Current |
Accepting new patients |
| John T. Mather Memorial Hospital | Current |
Accepting new patients | |
| John T Mather Memorial Hospital | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Emergency Medicine | Current |
Accepting new patients |
| John T Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Plandome, NY 11030
100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 317811 | NY | Yes |
Addresses
Primary practice location
25 Stonegate
Saint James, NY 11780-4228
Mailing address
25 Stonegate
Saint James, NY 11780-4228
Other providers in Saint James, NY
- Lisa Demartinis
- Scott David Demartinis
- Denice H Franco DO PLLC
- Dentistry Unlimited of St. James PLLC
- Monica Deschryver
- Noreen Bridget Digiose
- Adelle Catherine Dinnigan
- James Federick Donahue
- Danielle Alyssa Donnatin
- Jeselle Dookran
All providers in Saint James, NY · Emergency Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.